Related Terms

• Alkaloids, asparagin, bala (Sanskrit), barial, bariar, batyalaka, beejband, bhadraudanī (Sanskrit), bijabanda, bijband, brela, chikana, chiribenda, chitimutti, coronaric acid, country mallow, ephedrine, essential oils, flannel weed, fumaric acid, gelatin, hettuti-gida, hypaphorine, Indian ephedra, janglimethi, kharenti, khareti (Hindi), kisangi, kungyi, mallow plant, malva branca (Brazil), malva-branca-sedosa (Brazil), Malvaceae (family), malvalic acid, mayir-manikham, mucin, muttuva, palmitic acid, paniyar-tutti, phytosterols, potassium nitrate, rutin, samāmsa (Sanskrit), samangā (Sanskrit), Sida althaeitolia, Sida cordifolia spp., Sida herbacea, Sida rotundifolia, silky white mallow, simak, śītapāki (Sanskrit), stearic acid, sterculic acid, svarayastika (Sanskrit), tupkaria, tutturabenda, vasicine, vasicinol, vasicinone, vatya (Sanskrit), vatyālaka (Sanskrit), vātyodarāhava (Sanskrit), velluram, white mallow.

Background

• Bala (Sida cordifolia) is native to tropical regions of India and Sri Lanka. The plant is considered to be one of the most valuable medicinal plants in Ayurveda, the ancient traditional medical system of India. Bala is said to contain five of the six tastes, a rare property, indicating that it provides nourishment from the five mahabhutas (earth, water, fire, air, and space). Bala has been used to treat a wide variety of conditions, including aching joints and bones, asthma, chills, colds, cough, fever, flu, headache, nasal congestion, nerve pain, wheezing, and wounds, and it has been used as an aphrodisiac.

• Bala is associated with Parvathi, the ancient Hindu goddess of beauty and grace. The herb is part of a trio of "beautifying" herbs, together with ashoka and shatavari, associated with women in Indian herbal folk medicine.

• In India, bala is incorporated in many types of products, including moisturizing creams, massage and baby oils, and shampoo. Bala contains ephedrine, and several nutritional companies include it in weight loss products.

• Despite its long history of traditional medicinal use, clinical evidence supporting the use of bala to treat any condition in humans is lacking.

Scientific Evidence

Tradition/Theory

The below uses are based on tradition or scientific theories. They often have not been thoroughly tested in humans, and safety and effectiveness have not always been proven. Some of these conditions are potentially serious and should be evaluated by a qualified health care professional.

• Adaptogen, aging, analgesic (pain reliever), anti-inflammatory, antioxidant, aphrodisiac (increases sexual desire), asthma, astringent, bronchitis, cancer, cardiotonic, CNS (central nervous system) disorders, colic, constipation, cystitis, delirium, diabetes, diuretic (increases urine flow), dysentery, fever, gastrointestinal conditions, gonorrhea, heart attack, heart disease, hematuria (blood in the urine), hemorrhoids, hepatoprotection (liver protection), high blood pressure, hyperglycemia (high blood sugar), immunomodulation, leukorrhea (thick vaginal discharge), liver regeneration, nasal congestion, nerve pain, painful urination, sciatica (pain, tingling, numbness, or weakness in the leg), skin disorders, stomatitis (inflammation of mucous lining of mouth), tachycardia (rapid heartbeat), ulcer, vasorelaxant, weight loss, wound healing.

Dosing

The below doses are based on scientific research, publications, traditional use, or expert opinion. Many herbs and supplements have not been thoroughly tested, and safety and effectiveness may not be proven. Brands may be made differently, with variable ingredients, even within the same brand. The below doses may not apply to all products. You should read product labels, and discuss doses with a qualified healthcare provider before starting therapy.

Adults (18 years and older)

• Doses from clinical trials are lacking. One capsule containing 300 milligrams of bala has been taken by mouth. Five to 10 milliliters of a bala tincture diluted 1:3 in 25% alcohol has been taken by mouth daily in divided doses. Ten grams of bala per cup of water has been steeped for at least one hour and taken by mouth as tea.

• For elephantiasis, the juice of the whole plant has been pounded with a little water, made into paste with the juice of the palmyra tree, and applied to the affected area.

• For eye disease, a paste made from bala leaves has been applied to the affected eye.

• For general musculoskeletal soreness, bala oil has been used to massage the affected area.

• For gonorrhea, whole plant juice has been pounded with water and taken by mouth as tea in doses of 1/4 seer (approximately one cup).

• For wound dressing, a paste made from bala leaves has been applied to the affected area.

Children (under 18 years old)

• There is no proven safe or effective dose for bala in children.

Safety

The U.S. Food and Drug Administration does not strictly regulate herbs and supplements. There is no guarantee of strength, purity or safety of products, and effects may vary. You should always read product labels. If you have a medical condition, or are taking other drugs, herbs, or supplements, you should speak with a qualified healthcare provider before starting a new therapy. Consult a healthcare provider immediately if you experience side effects.

Allergies

• Avoid with known allergy or hypersensitivity to bala (Sida cordifolia), its constituents, or members of the Malvaceae family.

Side Effects and Warnings

• Bala may cause headache, heart attack, insomnia, irregular heartbeat, irritability, memory loss, nervousness, psychosis, seizure, slow or rapid heart rate, stroke, or tremor.

• Bala may cause CNS (central nervous system) depressant effects. Drowsiness or sedation may occur. Use caution if driving or operating heavy machinery.

• Use cautiously in individuals younger than 18 years of age, due to a lack of safety information.

• Use cautiously if taken for prolonged periods, due to a lack of scientific evidence.

• Use cautiously in patients with heart disease, including arrhythmia, coronary artery disease, cerebrovascular disease, and a history of stroke or transient ischemic attack, due to potential side effects from the ephedrine constituent in bala.

• Bala may cause changes in blood pressure. Caution is advised in patients taking drugs, herbs, or supplements that affect blood pressure.

• Use cautiously in patients with depression and anxiety, in patients sensitive to stimulants such as caffeine, or in patients with insomnia or tremor, due to potential side effects from the ephedrine constituent of bala.

• Use cautiously in patients using stimulants, including those that potentially contain ephedrine, due to the potential for additive negative effects.

• Bala may lower blood sugar levels. Caution is advised in patients with diabetes or hypoglycemia, and in those taking drugs, herbs, or supplements that affect blood sugar. Blood glucose levels may need to be monitored by a qualified healthcare professional, including a pharmacist. Medication adjustments may be necessary.

• Use cautiously in patients with previous monoamine oxidase inhibitor (MAOI) use due to potential side effects from the ephedrine in bala.

• Use cautiously in patients using other energizing and diet supplements that may contain ephedrine, due to the potential for additive negative effects.

• Avoid use in patients taking ergot alkaloids and cardiac glycosides, due to the risk of irregular heart beat.

• Avoid in pregnant or breastfeeding women, due to a lack of available scientific evidence.

• Avoid with known allergy or hypersensitivity to bala (Sida cordifolia), its constituents, or members of the Malvaceae family.

Pregnancy and Breastfeeding

• Avoid in pregnant or breastfeeding women, due to a lack of available scientific evidence.

Interactions

Most herbs and supplements have not been thoroughly tested for interactions with other herbs, supplements, drugs, or foods. The interactions listed below are based on reports in scientific publications, laboratory experiments, or traditional use. You should always read product labels. If you have a medical condition, or are taking other drugs, herbs, or supplements, you should speak with a qualified healthcare provider before starting a new therapy.

Interactions with Drugs

• Bala may lower blood sugar levels. Caution is advised when using medications that may also lower blood sugar. Patients taking insulin or drugs for diabetes by mouth should be monitored closely by a qualified healthcare professional, including a pharmacist. Medication adjustments may be necessary.

• Bala may cause changes in blood pressure. Caution is advised in patients taking drugs that affect blood pressure.

• Bala may increase the amount of drowsiness caused by some drugs, such as CNS (central nervous system) depressants. Examples include benzodiazepines such as lorazepam (Ativan®) or diazepam (Valium®), barbiturates such as phenobarbital, narcotics such as codeine, some antidepressants, and alcohol. Caution is advised while driving or operating machinery.

• Bala may also interact with antiasthma agents, anticancer agents, antidepressant agents or monoamine oxidase inhibitors (MAOIs), anti-inflammatory agents, antiobesity agents, cardiac glycosides, cardiovascular drugs, CNS depressants or stimulants, ergot derivatives, pain relievers, or vasodilators.

Interactions with Herbs and Dietary Supplements

• Bala may lower blood sugar levels. Caution is advised when using herbs or supplements that may also lower blood sugar. Blood glucose levels may require monitoring, and doses may need adjustment.

• Bala may cause changes in blood pressure. Caution is advised in patients taking herbs or supplements that affect blood pressure.

• Bala may increase the amount of drowsiness caused by some herbs or supplements.

• Bala may also interact with antiasthma agents, anticancer agents, antidepressant agents or monoamine oxidase inhibitors (MAOIs), anti-inflammatory herbs and supplements, antiobesity herbs and supplements, antioxidants, cardiac glycosides, cardiovascular agents, CNS depressants or stimulants, ergot derivatives, pain relievers, sedatives, or vasodilators.

Author Information

• This information is based on a systematic review of scientific literature edited and peer-reviewed by contributors to the Natural Standard Research Collaboration (www.naturalstandard.com).

References

Natural Standard developed the above evidence-based information based on a thorough systematic review of the available scientific articles. For comprehensive information about alternative and complementary therapies on the professional level, go to www.naturalstandard.com. Selected references are listed below.

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2. Dhalwal K, Deshpande YS, Purohit AP, et al. Evaluation of the Antioxidant Activity of Sida cordifolia Bala. Pharm Biol 2005;43(9):754-761.

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